Nonaccidental Head Injury in Infants — The “Shaken-Baby Syndrome”

Duhaime, Ann‐Christine; Christian, Cindy W.; Rorke, Lucy B.; Zimmerman, Robert A.

doi:10.1056/nejm199806183382507

Cited by 577 publications

(317 citation statements)

References 66 publications

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“…10,14,15 Particularly, extensive multilayered haemorrhages extending to the ora serrata (as seen in our patients), perimacular folds, and haemorrhagic macular retinoschisis strongly support this diagnosis. 14,15,26 Differences in incidence and severity of retinal haemorrhages are not the only characteristics deserving consideration when distinguishing accidental from abusive injury. In cases of doubtful traumatic head injury, interpretation of the CT helps distinguish between accidental and non-accidental causes.…”

Section: Discussionsupporting

confidence: 77%

“…Falls are considered to cause predominantly translational acceleration, which produces mainly focal brain damage. 8,15,20 In contrast, forces resulting in angular acceleration produce primarily diffuse brain damage. However, sudden impact deceleration in falls is mostly associated with an angular vector and deformation of the skull is accompanied by subdural cavitation tangential to the applied force.…”

Section: Discussionmentioning

confidence: 99%

“…27 However, interhemispheric subdural haematoma has been suggested as a particular characteristic of the shaking or shaking impact itself. 15,28 Two of the children with shaken baby syndrome had interhemispheric subdural haematoma. In comparison, none of the patients with accidental trauma developed interhemispheric subdural haematoma.…”

Section: Discussionmentioning

confidence: 99%

“…The extensive multilayered haemorrhages extending to the ora serrata are highly specific for shaken baby syndrome, even if unilateral. 10,14,15 Childbirth can also cause retinal haemorrhages because of mechanical stress. 16 The differential diagnosis of retinal haemorrhages in children also include coagulopathies (including haemophilia and hypoprothrombinaemia caused by vitamin K deficiency), leukaemia, persistent hyperplastic primary vitreous, retinal infections, Coat's disease, retinopathy of prematurity, and hypertension.…”

Section: Introductionmentioning

confidence: 99%

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Rare retinal haemorrhages in translational accidental head trauma in children

Sturm

Knecht

Landau

et al. 2008

Eye

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Section: Discussionsupporting

confidence: 77%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Rare retinal haemorrhages in translational accidental head trauma in children

Sturm

Knecht

Landau

et al. 2008

Eye

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“…[1][2][3][4] Poverty and stress are risk factors for abuse. 5,6 Studies have revealed increased rates of physical abuse after acute natural disasters.…”

mentioning

confidence: 99%

Abusive Head Trauma During a Time of Increased Unemployment: A Multicenter Analysis

et al. 2011

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WHAT'S KNOWN ON THIS SUBJECT:Abusive head trauma (AHT) is the leading cause of death from child abuse. Poverty and stress are recognized risk factors for abuse. No studies to date have evaluated whether there is a relationship between the economy and rates of AHT. WHAT THIS STUDY ADDS:Results of this study demonstrate a relationship between an economic recession and the rate of AHT. Given the high morbidity and mortality rates for children with AHT, these results are highly concerning. abstract OBJECTIVE: To evaluate the rate of abusive head trauma (AHT) in 3 regions of the United States before and during an economic recession and assess whether there is a relationship between the rate of AHT and county-level unemployment rates. RESULTS: During the 5 1 ⁄ 2-year study period, a total of 422 children were diagnosed with AHT in a 74-county region. The overall rate of AHT increased from 8.9 in 100 000 (95% confidence interval [CI]: 7.8 -10.0) before the recession to 14.7 in 100 000 (95% CI: 12.5-16.9) during the recession (P Ͻ .001). There was no difference in the clinical characteristics of subjects in the prerecession versus recession period. There was no relationship between the rate of AHT and county-level unemployment rates. METHODS: CONCLUSIONS:The rate of AHT increased significantly in 3 distinct geographic regions during the 19 months of an economic recession compared with the 47 months before the recession. This finding is consistent with our understanding of the effect of stress on violence. Given the high morbidity and mortality rates for children with AHT, these results are concerning and suggest that prevention efforts might need to be increased significantly during times of economic hardship.

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Prognostic Indicators for Vision and Mortality in Shaken Baby Syndrome

McCabe

Donahue²

2000

Arch Ophthalmol

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Objective:To study ocular and nonocular signs of patients diagnosed as having "shaken baby syndrome" and determine prognostic indicators for vision and mortality.Methods: Medical records of child abuse cases involving bilateral retinal hemorrhages were reviewed. Particular attention was paid to visual function and pupillary light reaction at the time of admission as well as the location of retinal hemorrhages, neuroimaging findings, ventilatory requirement, and associated skeletal injuries. These findings were correlated with visual prognosis and mortality.Results: Thirty consecutive cases met the criteria for review. At the initial visit, mean age of the children was 9.3 months (range, 1-39 months) and 12 children (40%) had at least fix-and-follow vision. Preretinal and intraretinal hemorrhages (93% [n = 28] and 100% [n = 30]) were more common than vitreous hemorrhage (10% [n = 3]).

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Nonaccidental Head Injury in Infants — The “Shaken-Baby Syndrome”

Cited by 577 publications

References 66 publications

Rare retinal haemorrhages in translational accidental head trauma in children

Rare retinal haemorrhages in translational accidental head trauma in children

Abusive Head Trauma During a Time of Increased Unemployment: A Multicenter Analysis

Prognostic Indicators for Vision and Mortality in Shaken Baby Syndrome

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